A multicentre prospective study evaluating the impact of proton-pump inhibitors omeprazole and pantoprazole on voriconazole plasma concentrations.

Abstract:

:Voriconazole is an antifungal metabolised by CYP2C19 enzyme, which can be inhibited by proton-pump inhibitors (PPIs). A prospective observational study was carried out to determine the influence of PPIs on voriconazole pharmacokinetic. The 78 patients included were divided into 4 groups: omeprazole (n = 32), pantoprazole (n = 25), esomeprazole (n = 3) and no PPI (n = 18). Patients with no PPI had no significant difference in plasma voriconazole concentration when compared with those with PPI (2.63 ± 2.13 μg/mL [95% confidence interval {CI} 1.57-3.69] vs 2.11 ± 1.73 μg/mL [95%CI 1.67-2.55], P > .05). However, voriconazole plasma concentration was significantly lower in patients treated with pantoprazole vs those treated with omeprazole (1.44 ± 1.22 μg/mL [95%CI 0.94-1.94) vs 2.67 ± 1.88 μg/mL [95%CI 2.02-3.32], P = .013) suggesting a greater CYP2C19 enzyme inhibitory effect of omeprazole. This study demonstrates the greater CYP inhibition capacity of omeprazole and should be helpful for the choice of PPIs for patients treated with voriconazole.

journal_name

Br J Clin Pharmacol

authors

Blanco Dorado S,Maroñas Amigo O,Latorre-Pellicer A,Rodríguez Jato MT,López-Vizcaíno A,Gómez Márquez A,Bardán García B,Belles Medall D,Barbeito Castiñeiras G,Pérez Del Molino Bernal ML,Campos-Toimil M,Otero Espinar F,Blanco Hortas

doi

10.1111/bcp.14267

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

1661-1666

issue

8

eissn

0306-5251

issn

1365-2125

journal_volume

86

pub_type

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